Healthcare Provider Details

I. General information

NPI: 1154226413
Provider Name (Legal Business Name): BAILEY TOMASZEWSKI RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 10/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

122 HIGHLAND DR
JACKSON MI
49201-9164
US

IV. Provider business mailing address

572 HERITAGE FARMS BLVD
CHELSEA MI
48118-1668
US

V. Phone/Fax

Practice location:
  • Phone: 517-740-7422
  • Fax: 517-315-4918
Mailing address:
  • Phone: 517-740-7422
  • Fax: 517-315-4918

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number2902020028
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: